The joys we choose

Ok, so I'm sitting here at 4am after waking up with a fussy child, and I can't go back to sleep. As a result, I think...maybe a little too much:) I wonder about the wonderful children we have and what makes them so beautiful to me. How can I love something so much that gives me so much anguish sometimes? It is difficult to explain to someone the joys of motherhood who just doesn't see it the same way you do. It's so easy to make a list of the horrible things about being a mom.....no sleep, no thank-you, giving constantly, working to keep things together, mentally exhausted, tantrums, fights....the list could go on and on, So, why in the world do I choose to do this.

Here's one reason why....the other night my daughter came to me in tears....bawling...asking me to please not get mad at her. I gave her a hug and told her no matter what happened I would always love her. So she told me the horrible news. She had LIED to me:) (I had known about this..she is actually a pretty good liar). And she felt horrible. She couldn't sleep at all because she had been thinking about it. And I....I wanted to jump up and shout for joy. I was so happy that she 1) felt like she was safe and could confess this to me, 2) understood that what she did was wrong 3) something I was teaching her was getting through to her. Funny, the joys of motherhood huh, but I had to pull myself together and actually think of a punishment for her:) We hugged and talked and enjoyed just being with each other after that. But even the joy of that story can't put it all into words about the joy that comes from motherhood.

I often feel the same way about birth and pregnancy. I think we all know the list of things that is difficult with that one. But here's the cool thing....you are creating life. Life. A sacred child, that you soon learn to love and adore, is growing and starting it's life within your own. With each day of pain, nausea, exhaustion, loss of self and sleep, a new life is being formed and we are allowed to be a part of that. That amazes me.

And to me, the fact that we are giving birth, is more important than how we give birth. My experience of natural child birth, has made me reflect more on that than anything, but I don't think it should be exclusive to giving birth without drugs. I wonder though, if the power of birth and life would mean as much to me if I hadn't given birth naturally. I understand pain so differently now, as well as sacrifice...would that have changed? I'll never know. We live the lives we've chosen. But all I can say is, I'm grateful to be a mother, and I'm grateful for the lessons I've learned through the trials of pregnancy, labor, birth, and motherhood. I'm grateful for the joys of bringing life into this world and the joys of continuing to shape and mold those lives. It's indescribable.

H1N1 and hospital safety

I am doing my own independent research. The CDC is now recommending that infants be removed from their mothers who after birth whose mothers are showing symptoms of H1N1. See link here:http://www.cdc.gov/h1n1flu/guidance/obstetric.htm"Place the ill mother in isolation after delivery (http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm). The mother who has influenza-like-illness (http://www.cdc.gov/h1n1flu/casedef.htm) at delivery should consider avoiding close contact with her infant until the following conditions have been met: she has received antiviral medications for 48 hours, her fever has fully resolved, and she can control coughs and secretions. Meeting these conditions may reduce, but not eliminate, the risk of transmitting influenza to the baby. Before these conditions are met, the newborn should be cared for in a separate room by another person who is well, and the mother should be encouraged and assisted to express her milk. Breast milk is not thought to be a potential source of influenza virus infections. As soon as all conditions are met, the mother should be encouraged to wear a facemask, change to a clean gown or clothing, adhere to strict hand hygiene and cough etiquette when in contact with her infant, and begin breastfeeding (or if not able to breastfeed, bottle feeding). She should continue these protective measures, both in the hospital setting and at home, for at least 7 days after the onset of influenza symptoms (http://www.cdc.gov/h1n1flu/guidance_homecare.htm#c). If symptoms last more than 7 days, she should discuss the symptoms with her doctor. Protective measures might need to be continued until she is symptom-free for 24 hours. People who are once again well 7 days after getting sick are thought to be at low risk for transmitting the virus to others."
I am wanting to know if this is really necessary. I would like to look at three groups of women 1)those who have symptoms and have been isolated from their baby but cont. to feed breast milk 2) those who have had no symptoms, were given baby within 2 hours after birth and breastfed 3) those who have no symptoms, but were not with baby within 2 hours after birth and breastfed or expressed milk for infants. All of these should be full terms infants (37-42 weeks) . They can be born at the hospital, or alternative birthing area.
I am hoping to follow these babies for six months to see if who is getting sick. In order for this to be a valid study, I need as many moms as possible to participate, so please e-mail this to friends and family. I will be reposting this every month, just to see if their are new people who are interested. I will also be doing this until the flu season is over. Thanks, Rachelwww.thebeginningofmotherhood.blogspot.comrachel.leavitt@gmail.com

So what position should I be in anyways?.....

This post comes from a question about positions during the pushing stage of labor. In one of my previous posts http://thebeginningofmotherhood.blogspot.com/2009/02/emergency-pain-control.html, I mentioned how you should not give birth laying on your back. So, if that's the case, what position can you push in? Answer: just about any position but that one:)

Here's the extended answer:)

It has been shown that being in an upright position helps to decrease the amount of pushing time, decrease the amount of tears, and decrease the amount of instrument deliveries. These positions include squatting, sitting, and on your hands and knees. There are good things and bad things about all of these. Obviously squatting would get tiresome, but if you have good help, they can help support you from behind. Hands and knees can also get tiresome, but it is one of the best positions to turning baby into the right position. You can also use a birthing stool to sit on, or if you are at the hospital, get the bed positioned to help support you sitting up. This is one of my favorite positions.

For those who have epidurals, or are just plain exhausted, the side-lying position has been shown to help. Essentially you have one leg raised while you are pushing on your side. With an epidural, you can also have the head of the bed raised to allow you to be more upright. Just make sure you are fully up and not just half way as this will decrease the space in your pelvis.

A good book to look at for positioning is Penny Simkins book, Labor Progress. She does a wonderful job of explaining different positions throughout the labor and why you would use them.

If you feel a need to be in any kind of position, I would stick with that. Many times, a woman's body can tell how they need to be to help move that baby down. Your biggest hindrance will be with medical staff that aren't used to these positions. I would make it clear from the get go that you want to push differently. Talk to your doctor about this also. Some are fine with doing whatever, and others are pretty stuck in the lying on the back mode.

I also had a question about doula's. First off, I'll say that I never had a doula, but probably could have used one. I have a wonderful supportive husband, but I feel like a doula who has been trained and been to many births, has experiences that neither I nor my husband had had at the time. Plus a doula allows the husband to take breaks when needed. A good doula will help the husband in his supportive role. I also think that there is something different about how men and women think, and having a women's support along with your husbands would make a difference.

Studies on doula's have shown that women who use doula's have shorter pushing times, less instrument deliveries, and breastfeed longer(Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG [J Obstet Gynecol Neonatal Nurs] 2009 Mar-Apr; Vol. 38 (2), pp. 157-73.).

I would interview them first to see if they would fit well with what you want to do and how you feel about things. If you plan on having a hospital birth, I would also try and find a doula that has worked well with the medical staff in the past. If money is an issue, try and request a nurse that has had natural birth experience. Sometimes, you can get a nurse to help with the labor support if needed.

References:

The Journal Of The American Osteopathic Association [J Am Osteopath Assoc] 2006 Apr; Vol. 106 (4), pp. 199-202.

The Journal Of Perinatal Education: An ASPO/Lamaze Publication [J Perinat Educ] 2006 Fall; Vol. 15 (4), pp. 6-9.

Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG [J Obstet Gynecol Neonatal Nurs] 1997 Nov-Dec; Vol. 26 (6), pp. 727-34.

Empowering home birth

"Home birth is very empowering. I did something joyfully that most women dread. They don't believe me when I say I'd rather give birth than see the dentist. With each birth, as I took more control and made the decisions, I grew up. I can make hard decisions and I can do hard things. It's probably the best therapy I ever had because it came from within and helped me realize who I am"

This was from a woman who wrote her experience to a group I am a part of.

Acceptance

When I was pregnant with my first child, a local birth center was recommended to me. I had never thought about different childbirth options, but thought it might be a good way to go and see what birth was like without an epidural. I went into birth, knowing full well that I would feel pain, but I accepted that. Of course, I didn't understand at that point what that really felt like, but there was a sense of peace in that decision for me. I wasn't adamant about how I wanted my birth to be, I just let it unfold with all the mystery that it held.

After that birth, I knew three things: 1) childbirth did hurt:) 2) it was hard work, 3) it was something I was capable of doing. I found great satisfaction with my birth, even though it was painful, and because of this I realized that joy, happiness, and contentment are not related to the amount of pain we feel.

I found this quote in a book I've read that describes difficulties in life, but I feel like it relates quite well to how I've viewed the pain of childbirth.

"Life is difficult...Once we truly know that life is difficult-once we truly understand and accept it-then life is no longer difficult. Because once it is accepted, the fact that life is difficult no longer matters" (From the Road Less Traveled by M. Scott Peck).

The pain of childbirth is, of course, something we must all come to terms with, and we all deal with it in different ways. I would just hope that we can find room to allow it to help us grow, no matter how we choose to deal with it.

H1N1

I got a few questions sent to me, so I thought I'd post them here as I'm sure a lot of people are wondering about these things.

"What are the hospitals doing to protect mothers and babies from H1N1?"

To the dismay of many, hospitals all over are limiting visitors and not letting children into LD units. While this may seem harsh, one of the biggest problems at hospitals is infections. If you are choosing to have your baby at a hospital, I think that this is a good way to limit the amount of germs that are spread around. At the hospital I work at, they are making anyone who comes in with flu symptoms put on a mask. They are also trying to keep the sick moms in a completely different area than those who are not sick. I work for a corporation that owns three hospitals in my area. If there was to be a huge outbreak, one of those hospitals is designated as the sick hospital. I would assume that those who are caring for sick patients will only be with sick patients. That means that if someone is healthy, they won't get a nurse that is also taking care of someone who is sick. If someone is sick, the nurse is required to put on a gown, gloves, and mask. While I didn't really want to be vaccinated:), all the nurse were required to be. As you can spread the virus before symptoms show up, I was ok with that.

Do you think there is an increased risk to newborns in the hospital because of this outbreak?

Anytime there is virus' and germs around, newborns are at risk. As there are many people coming and going at the hospital, there are more germs there. That has always been the case though. Chances are, with the way this virus is spreading, the newborn would be exposed to it pretty much anywhere. The problem with hospital bugs, though, is the mom hasn't had a chance to develop an immunity to it and thus pass it on to baby. At home, the mom is exposed to all the germs there and has passed on the antibodies to her infant already. Therefore, I couldn't say for sure if there is an increased risk. I think it would depend on what is already in your community. As far as I know, though, no newborns have died from this virus thus far.

What would you suggest (to help prevent infection)?

Breastfeed!:) Whatever mom's body produces to fight off the virus will be passed on the infant. Try and get a good first feeding in. Colostrum is amazing stuff. I would also make sure that whoever walks in that room with mom and baby are washing their hands or using hand sanitizer. Make sure your nurses and doctors do this too. I personally would also keep baby with you as much as possible instead of taking it out to be exposed to others germs. I would ask for the nurses to do all the stuff they need to do in the moms room. I'm not sure if this would be accepted, but it wouldn't hurt to ask. I just think that limiting the exposure of baby to other people would be the best thing in the hospital. Moms should also make sure they are getting enough to eat and are limiting their stress. These things make a huge difference in our ability to fight off disease. I know these aren't used that much, but I think a post partum doula would be so helpful with this.

Now here's the tricky part for mom in labor...fear and stress can lead to a more difficult labor, therefore, I feel like it is essential that we don't let these emotions take us over. Just know that there are always things we can do and have control over, and there are somethings we can't control. The trick is learning to do what you can and letting the rest go.

Addendum

I accidental published that last post. I had just written it down as a thought to look at later:) But since it's out, I thought about and wrote more...just so those who follow me know...it's now ready to read:)

Humanistic birth

"Women are not seeking “designer” births. They are looking for humanistic care during pregnancy, labor and birth and are increasingly having difficulty finding that in many hospitals."*

Sorry, I posted this one as just a thought to myself to be saved later to mull over. So, I'll go ahead and do my thinking now since I already put it out there:) I saw this quote and started asking myself, "what is humanistic care"? And what is it that women are seeking in birth anyways? We all go in with specific expectations. Some want more natural births, some want a whole planned out script, some just want to get that baby out however it comes. But I think all of us want to be treated with dignity and respect. We would all like to think that our thoughts and ideas matter to those taking care of us.

Labor is a hard one to do this with, though. Things can happen so fast, and many people that you don't know are suddenly around you. I feel like often times, the emotional roller coaster that mom is going through is sometimes over looked. Sometimes, it's just the touch of a hand, or the calm quiet voice that we need the most. Speaking as a nurse, we may not like all the moms we are serving, but I have come to the conclusion, that we need to learn to not only like them, but to love them. A more humanistic experience means a lot more work, a lot more learning, and a lot more focus on the needs of moms and babies. And it is definitely not something to just shove to the side as a good idea...it is absolutely necessary for us to understand that birth needs to be surrounded by loving and caring people.

*http://www.nhregister.com/articles/2009/10/15/opinion/doc4ad699e65861c085403314.txt

Positive birth image

I thought this is a great look at what a birth can look like. I think we get too many negative images, so I wanted to share this one.

We were born together

"My mother was me and I thought that on the day I was born, we were born together".

I came across this quote awhile ago, but apologize as I don't remember where I found it. I thought this was an interesting idea about how birth is really the birth of both the mother and the baby.

In this life, we do all sorts of changing and learning and growing. I feel like there is nothing, though, that compares with the change we go through as we delve into motherhood. Nothing so completely takes over your life, or so completely changes your ideas of what joy and sorrow are. As I remember my own births and the births of the women I take care of, I recognize this as a time of transformation. This is where we begin the process of discovering what motherhood really means to us.

You're Never Alone

I felt like this video has a lot of meaning for going

through different trials in our lives. I felt like it

could also be applied to how we view our births.

Obviously, for those who are religious, it has a

different meaning. I also believe, though, that it holds

meaning beyond that. When we are faced with

trials, it helps so much to feel like we are supported,

that someone is there for us, and that we have

some idea of the blessings that we will receive at

the end of our labor. I find it interesting, also, that

when I speak with women about their labors, support

is one of the things they found most helpful. That is

was either the percieved lack of support, or the

support they recieved, that made a difference in

how they felt during their labor. I think at times, that

is what makes the difference in many aspects in

our lives.

Guest Post-Carol Van Der Woude

After working in the hospital as a labor and delivery nurse for many years,

I began assisting at homebirths. My experience with homebirth enabled me to see the intuitive wisdom of a woman in labor. I learned to shift from the attitude of managing labor to one of supporting labor.

The difference came in observing carefully (without intervening), listening and offering encouragement. Sometimes I made suggestions, offered massage, or nourishment. I learned that many women had an inner sense of what they needed to do.

I learned to read signals given by contraction patterns and pain. A midwife, a nurse or a doula can enhance a woman’s ability to work with her labor. Then the work of labor takes on an intense but amazing rhythm. I tried to capture this in my poem, Morning Light.